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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�. � 1 �� -�, �� k��-- ��.1 � �, <br />_ <br />PROJECT ADDRESS <br />, `.�`l � _ ���-; <br />, <br />`"-�.f_� C�2�,fi��S ���'fldov LLG � �� �i� ����� �i���cC'� ,nl7�a����� �'�1���-���7�- -� �['? f <3� <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />c-� <br />� <br />� � ._%/ � � <br />Electrical Contractor <br />Mail Address <br />Mail Address <br />�,=� ` :�: �.-.��^ �f'i ? % (,..� <br />tate License Number <br />�C �1��.ti�tvi�c� <br />Proposed Use of Building <br />� <br />City <br />City <br />State/Zip <br />State/Zip <br />_�C�u ��� � <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Phone <br />Phone <br />< , <br />Description of Work to Be Done: ��-p 1����"���. ;}`�,r�C),�.�. E7�r �;^ ��'4�-t�} ��'�'�,����, '�t.:� �r�j ; � �� <br />� �, <br />�� ' "� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />FEE <br />�J � � �.1 <br />,_, <br />I hereby certify that I have read and examined this applicafion and know the same to be f; ue and s I��`� _� O v <br />correct. All provisions of laws and ordinances governmg th�s type of work wrll be completed <br />whether specified herein or not. The granfing of a permit does not presume to give aufhority to <br />violate or cancel the provisions of any other state or local law regulating consfruction or the <br />performance of construction. That 1 am authorized by the owner of this property to perform the <br />work for whrch applicatron is made and 1 comply with the Stafe Contracfors Law 18.27 RCW and <br />296.200 WAC. <br />> <br />aturd Date <br />